Health Insurance

which focuses on complementary and alternative approaches to medicine (CAM), including a chiropractic service, neurology, neurosurgery and more. This is a beneficial introduction to Cayman’s medical field, and refers back to old holistic and naturopathic approaches to medicine in which so many generational-Caymanians were very reliant on. The HSA are also hoping to be more inclusive by incorporating braille throughout the facility, to make it more accessible to those with vision impairments. They’ve also outfitted their waiting room with ergonomic seating designed for seniors, ensuring patients feel comfortable in a nurturing, aestheticallypleasing environment. Furthermore, at the Cayman Islands Hospital, HSA are prioritising a reduction in their energy consumption and carbon footprint by spending approximately $2 million on green investments. By installing energy-efficient thermal windows, a solar photovoltaic system, four advanced chillers, LED lighting and a hospital recycling programme, it is predicted that such initiatives will provide greater sustainability in the public health sector, whilst also benefitting the patient experience at the HSA.

In the private sector, we are seeing a similar interest in healthcare facilities wanting to prioritise inclusivity and accessibility for all patients across the Cayman Islands. For instance, Health City Cayman Islands (HCCI) located in East End expanded their services and opened their new satellite medical care centre in Camana Bay. This operates as both a general practice clinic and a specialist clinic, offering more targeted medical services including orthopaedics, medical oncology and cardiology. They now hope to extend their services further by building another 50+ bed, CI$100 million hospital at the edge of Camana Bay, specialising in neo-natal care and cancer treatment. The project is expected to take two years to complete – a 70,000 sq ft site removing the need for the trek to East End in emergency circumstances – something Dr Binoy Chattuparambil (Clinical Director of HCCI) has said has caused tragic casualties in the past. Additionally, in April 2021, HCCI also opened their Cayman Brac clinic in Stake Bay.

Furthermore, plans have been announced for a $350 million medical tourism hospital: Aster Cayman Medcity. This will initially include a 150-bed hospital in West Bay, which will offer telemedicine services, and eventually expand to provide 500 beds and an infusion therapy facility. Such initiatives will provide more jobs for residents in the healthcare field; local developer Gene Thompson predicts nearly 2,000 positions will need filling, both directly and indirectly, and Caymanians would be given precedence with construction roles.

Another interesting development was the opening of Total Health in Grand Pavilion – a full service, advanced, primary care hospital offering fully comprehensive healthcare. The 5,500sq ft facility also has an on-site Laboratory and Imaging team, allowing for early detection of diseases and timely intervention. By offering a plethora of personalised, preventive, and accessible care, we hope such multi-service facilities further educate and empower others on the benefits of a healthy lifestyle, however, this always depends on one’s ability to access such services and/or benefits.

The National Vaccination Programme The official roll-out of Pfizer/BioNTech SARS-CoV-2 vaccines started with a ‘Priority-Grouping System’, which allowed healthcare workers and first responders, those over the age of 70 and other frontline staff to receive the vaccine. As more jabs became available and repatriation flights from the UK continued, Cayman was in an incredibly fortunate position, receiving almost 20,000 doses. As of June 2021, the Pfizer vaccine was approved for children aged 12+; various locations therefore soon became vaccine clinics, open to all aged 12 and over. Visit www.exploregov.ky for more information on current vaccination schedules and locations.

The National Vaccination programme did not come without its scepticism, though. Many were, and still are, apprehensive about the long-term side effects of the vaccine. Although it (Pfizer) has been scientifically proven to be effective in lowering the risks of asymptomatic transmission and the contraction of COVID-19, the Cayman Islands Government (CIG) announced an unfortunately slowing rate in vaccination uptake in April 2021. This was worrying for officials, as such a failure to meet expected vaccination levels stunted the possibility of proceeding with a phased border reopening plan. To incentivise more of the population to get their first dose before June 9th 2021, the CIG launched ‘The Vaccination Challenge’ as the vaccines at the time were set to expire on 30th June 2021. The consensus among the CIG, Public Health and the Chief Medical Officer, Dr John Lee, was that the Cayman Islands must reach a threshold of at least 80% of the population vaccinated (based on a figure of 71,106 people) before entering Phase 4 of the PACT Government’s ‘Phased Border Reopening Plan’ (announced on 8th July 2021). Phase 4 was planning to allow a limited number of tourists to enter the island from 14th October 2021. However, following the report of several positive cases in September 2021 (which may have been due to on-Island transmission or otherwise) the PACT Government have announced that they will ‘pause’ proceeding to Phase 4 until early 2022. Nonetheless, at the time of publication, the Government are still attempting to encourage more locals to receive their second jabs, to help us reach Premier Wayne Panton’s goal of vaccinating a large majority of the population.

HEALTH INSURANCE

Given the broad variety of services available, Cayman can provide quality care for most medical situations. However, healthcare and medications are costly, so it is essential that you either have a health insurance policy that covers travel

if you are visiting, or health insurance coverage if you are a resident. With local life expectancy continuing to climb, child vaccination rates hovering over 90% (except for COVID-19), and 94% of the population covered by health insurance, the partnership of public, private and nonprofit entities in the field of healthcare continues to be of benefit to all groups within the community. To learn more about community groups that support and advocate for high quality patient-care, take a look at the listings in the Community Life chapter.

Health insurance is a type of insurance coverage that covers the cost of an insured individual’s medical and surgical expenses. In Cayman, this is categorised into one of two types: private or public. Every resident in Cayman is required, by law, to have at minimum health insurance which covers basic medical expenses. Employers are mandated to provide a Standard Health Insurance Contract (SHIC) plan for all their workers from their very first day of employment, regardless of the type or length of their work permits. This requirement extends to any unemployed dependent spouse and child(ren) living on-Island. The same applies to the self-employed, those in a partnership and those with permanent residency without the right to work.

Legally, an employer only has to pay half of the single premium, based upon the lowest-costing plan made available to the staff, and the employee pays the other 50%. Given that premiums can change year to year, always do your research, and negotiate with your employer that they pay more than the minimum contribution level; particularly in relation to the cost of your dependants, (for which you might have to pay 100%) and any premium differentials for upgraded benefit packages.

Insurance can be purchased by residents on an individual or family basis, or you could be enroled on group coverage via your employer. Employer groups, especially those with over 10 employees, will have a greater variety of plan options to choose from. Individuals and employers may work directly with these various insurance companies or secure the services of an independent broker to evaluate their insurance options. The insurance companies pay the brokers for the assistance they deliver so most brokers’ services are at no cost to the client. Some brokers may be agents of a particular insurance company, or may only acquire quotes from just one or a very limited number of insurers, so you may wish to query which insurers they work with before choosing. For the basic SHIC plan, the insurance companies will ask for 12 months of medical history plus details on any current conditions or medication. For upgraded policies, the applications may require a more extensive medical history, thus it is a good idea to bring copies of your medical records with you (and those of your dependants). This will also help your new or existing Cayman doctors to provide you with their best care. If you have chronic medical conditions or immediate surgical needs, expect that these could be

restricted to the minimum benefit levels on your coverage. We recommend that people coming from overseas with medical issues should request that their proposed employer seek a pre-approval of their insurance as part of their decision-making process to ensure they are able to obtain the coverage levels they need.

Once you have been with a Cayman insurer for 12 or more months with no more than a three-month break in coverage, and even if you have developed problems in the meantime, the next insurer cannot add new restrictions to a similar level of coverage. The only exceptions are cases of non-disclosure on the application form or if you are seeking a large upgrade in your coverage. Since pre-existing conditions may be restricted, be sure to check before cancelling your insurance at home, as you could potentially get global coverage on your existing health insurance to cover you in Cayman. However, you are still required by law to have a minimum SHIC plan from a local provider so make sure you coordinate the benefits between the two health plans.

Plans vary from the basic SHIC to very comprehensive major medical world-class plans. The Cayman Islands Monetary Authority and the Health Insurance Commission license and regulate the health insurance companies together. The SHIC plan is the primary Governmentregulated contract and covers about a quarter of Cayman’s residents. However, most employers offer higher than mandated coverage and all other health insurance plans are based around the Health Insurance Acts & Regulations, including the outline of the basic SHIC benefits. In 2013 these were increased and now cover at minimum up to CI$100,000 major medical per annum with a CI$1,000,000 lifetime maximum for each person. This includes hospital, surgical, chemotherapy and radiation services along with emergency care. All SHIC plans have limited local outpatient benefits and any overseas care is usually restricted to the kind of major care unavailable in Cayman. The more comprehensive plans offer wider access to overseas services, larger per annum and lifetime allowances (e.g. CI$500,000, CI$1,000,000 and CI$2,000,000 or higher could be available within a calendar year), fuller prescription coverage, more outpatient services and options for dental, optical and/or life insurance benefits.

The cost of insurance plans will vary with age, gender, benefits and employer size. For example, a basic SHIC plan without dental and vision currently costs in the vicinity of CI$167 per month per employee, whereas a medical plan with enhanced outpatient benefits typically runs 20-30% higher than SHIC. More comprehensive benefits, including doctor and specialist visits, extra preventative care, dental, vision and prescription coverage can cost up to CI$500-$900 per month, per individual, and about CI$450-$850 without dental and vision. The premium rates are roughly doubled for a couple, and about tripled for a family rate. As a general rule, adding one dependant is about twice the single monthly costs, and adding two or more dependents is usually in the range of three times the employee-only monthly premiums.

The high cost of our health insurance has been known to discourage people from retiring here. Keep in mind that under some group plans, the amount available per annum may reduce at the typical ‘retirement age’ and most employers in Cayman do not extend health insurance benefits to retirees. Most medical and some dental practitioners accept local insurance ‘on assignment’ provided that the insurance company guarantees payment and the deductible, if applicable, has been met. This means that the doctor or dentist will claim work done directly from the insurance company on your behalf. Anything not paid by your insurance company is your responsibility. If any employer or individual wishes to obtain additional coverage above what is given by the company with which they are employed, or the Government, they are able to do so, but, beware that the Health Insurance Commission cannot regulate the rates charged. All medical payments by insurers are based on the Standard Health Insurance

Helping you manage the costs, people risks, and complexities of employee benefits.

Our benefits professionals service clients in more than 150 countries. Deeply knowledgeable about local markets, we help clients create a healthy and engaged workforce, optimize cost and manage risk, and simplify and enable program delivery.

Laverne Jackson

+1 345 936 5715 laverne.jackson@marsh.com

Beth Henry

+1 345 525 5751 beth.henry@marsh.com

marsh.com

A business of Marsh McLennan

Fee (SHIF) schedule, which can be found at www.dhrs.gov.ky. (Look for the ‘Standard Health Insurance Fees’ on the Health Insurance Commission page). Medical providers are not required to charge within the SHIF fees, and balances above the SHIF fees are the patient’s responsibility. For large medical services, it is not unreasonable to ask for a written quote, which is called a ‘predetermination of benefits’ or ‘preapproval for medical necessity’. If a retiree or visitor to Cayman requires medical assistance on the Island they will usually pay upfront for services, keep all receipts and submit a claim once they return to their home country. The receipts will usually need to be fully itemised with diagnosis information and include international disease codes. As a visitor you should request that a claim form be completed using Cayman’s standard claim form. It is advised that you call your insurance provider before travelling to Cayman to verify how your benefits will work here. You may also wish to check if your insurance network extends to any local providers. It is possible that insurance companies have already set up a relationship with local providers, which can save you out-of-pocket costs. However, it is not mandatory for medical facilities to accept overseas insurance. Residents who will have relatives visiting are recommended to inquire about their visitors’ insurance too. If your visitors’ insurance will not cover them whilst in Cayman, they should be encouraged to seek a travel policy to protect them. For more information on health insurance for kids, turn to the Health chapter of the 2022 edition of Cayman Parent magazine.

Health Insurance Providers The Health Insurance Act (2013), Health Insurance Regulations (2013) and Insurance Act (2010) provide a framework for monitoring the Cayman Islands’ health insurance industry.

Approximately 94% of Cayman’s population is covered by health insurance, which is mandatory for all residents, and must be obtained through an approved insurance provider. This includes the Government-owned CINICO, as well as:

Aetna 2nd Floor, North Building, Caribbean Plaza Tel: (345) 623 8621 Email: McCallisterA@aetna.com. Offers high quality health insurance plans for your home and travel needs.

BAF Insurance Company (Cayman) Ltd. Dot Com Centre, Dorcy Drive, Industrial Park Tel: (345) 949 5089 caymancustomerservice@mybafsolutions.com Provides affordable health insurance plans designed to meet the needs of a wide crosssection of residents of the Cayman Islands.

CG BritCay Ltd. BritCay House, 236 Eastern Avenue, GT Tel: (345) 949 8699 Email: medical_ky@cgcoralisle.com www.cgcoralisle.com CG BritCay Ltd. is a member of Coralisle Group

“Opening Doors to Wellness For Our Members”

Government-owned INSURANCE COMPANY which provides HEALTH INSURANCE COVERAGE to residents of the Cayman Islands

PRODUCTS

CINICO currently offers health insurance products in the following categories:

Civil Servants & Pensioners

Health care coverage available to Civil and Public Servants and their dependents.

Seafarers & Veterans

This plan provides health insurance coverage to qualified Seafarers, Veterans and their dependents, and is administered on behalf of the Ministry of Finance.

Standard Health Insurance Contract (S.H.I.C.) Plan

As it is a legal requirement for all residents of the Cayman Islands to have health insurance coverage, this plan provides the minimum coverage required by law, and is available to all residents upon application and payment of premiums.

SERVICES

Medical Case Management & Claims Units

There is no doubt that with this level of in-house expertise, as well as exceptional customer service, CINICO’s members enjoy the invaluable benefits of a sense of security and peace of mind.

Cayman Centre, 1st Floor, Airport Road | P.O. Box 10112, Grand Cayman KY1-1001 Tel: 345-949-8101 | Fax: 345-949-8226 | www.cinico.ky

Ltd. and is the number one provider of group major medical health insurance coverage in the Cayman Islands. SEE AD PAGE 147

Cayman First Insurance Company > 17 Vibert Bodden Drive, Cayman First Centre, George Town > Countryside Shopping Village, Savannah Tel: (345) 949 7028 Email: askus@caymanfirst.com www.caymanfirst.com Cayman First is an industry-leading Health and Property & Casualty insurer, delivering bestin-class products and services that respond to the changing needs of individuals, households and businesses. SEE AD PAGE 146

Cayman Islands National Insurance Company (CINICO) Cayman Centre, 1st Floor, Airport Rd, GT Grand Cayman: Tel: (345) 949 8101 Cayman Brac: Tel: (345) 948 8101 www.cinico.ky The Government-owned insurance company offers the Standard Health Insurance Contract

SEE AD PAGES 143 & 295

Pan-American Life Insurance Company of the Cayman Islands Unit 221, Cannon Place, North Sound Road Tel: (345) 949 8304 www.palig.com/cayman A member of the Pan-American Life Insurance Group, it serves the employee benefits needs of local and multinational companies.

Health Insurance Brokers The advantage of working through an insurance broker is that they understand the health insurance market and can often compare costs, terms, and coverage options. This is a great way to find a plan that is perfectly suited to your needs.

Aon Risk Solutions (Cayman) Ltd. 18 Forum Lane, 2nd Floor, Camana Bay Tel: (345) 945 1266 or (345) 914 8945

www.aoncayman.com

and disability. SEE AD PAGES 142 & 293

Cayman Insurance Centre (Insurance Brokers) Cayman Business Park, Unit A3, 10 Huldah Ave Tel: (345) 949 4657 Email: info@cic.com.ky or health@cic.com.ky www.cic.com.ky Corporate and Individual health insurance coverage. Celebrating over 45 years.

SEE AD PAGE 144

Bogle Insurance Brokers Ltd. Unit 34 & 35 Pasadora Place Tel: (345) 949 0579 or (345) 623 0579 Email: service@bogleins.com Caymanian owned and operated, with a wealth of knowledge locally and internationally.

SEE AD PAGE 145

F.I.S. Insurance Brokers Ltd. Paramount Building, Shedden Road, GT Tel: (345) 945 5616 or (345) 623 5616 Email: info@fiscayman.com They offer individual health insurance plans for three insurance companies: CG BritCay, Cayman First and Vanguard Risk Solutions.

Marsh Management Services Cayman Ltd. Governors Square, 23 Lime Tree Bay Avenue Main Tel: (345) 949 7988 Email: caymanoffice@marsh.com www.marsh.com Marsh provides clients with a single source for risk management services. Their experienced team of professionals can assist by developing a comprehensive employee benefits programme, including group medical and ancillary plans.

SEE AD PAGE 294

Vanguard Risk Solutions 3rd Floor, Cayman Financial Centre, 36A Dr Roy’s Drive, George Town Tel: (345) 949 5836 Email: info@vrscayman.com www.vrscayman.com A leading insurance broker in the Cayman Islands for over 35 years providing a wide selection of comprehensive health plans for both individuals